不同压力对减轻老年冠心病介入治疗患者前臂血肿的效果

doi:10.3761/j.issn.0254-1769.2020.01.012

摘要/Abstract

摘要：

目的比较不同袖带压力对老年冠心病患者经桡动脉行冠状动脉介入治疗后前臂血肿的压迫效果。方法 2016年3月—2019年2月,选取某三级甲等医院行介入治疗后发生前臂血肿的94例老年患者,采用随机数字表法分为试验组和对照组,每组47例,均采用血压计袖带充气加压法压迫血肿,试验组、对照组血压计袖带充气压力分别为高于患者收缩压30 mmHg（1 mmHg=0.133 kPa）与20 mmHg,压迫5 min后排气减压1 min,重复5个周期,其中试验组排气减压至患者舒张压,对照组排气减压至0 mmHg。观察两组血压计袖带压迫过程中患者的舒适度、疼痛情况,在压迫完成即刻与压迫完成30 min后,观察患者臂围、前臂张力及肿胀程度。结果压迫过程中,两组患者舒适度、疼痛的比较,差异无统计学意义（P>0.05）,压迫完成即刻,两组前臂肿胀程度的比较,差异无统计学意义（P>0.05）;压迫完成即刻与压迫完成30 min后,试验组患者臂围及前臂张力改善情况优于对照组,差异具有统计学意义（P<0.05）,压迫完成30 min后,试验组前臂肿胀程度低于对照组,差异具有统计学意义（P<0.01）。结论血压计袖带充气压力高于患者收缩压30 mmHg,维持压力5 min后排气减压至患者舒张压,维持压力1 min,重复5个周期,有利于减小患者臂围、改善前臂张力和肿胀程度。

关键词: 冠心病, 冠状动脉介入治疗, 血肿, 血压计袖带压迫, 护理

Abstract:

Objective To compare the effects of different cuff pressures on compression of forearm hematoma after transradial coronary intervention in elderly patients with coronary heart disease. Methods From March 2016 to February 2019,94 patients with forearm hematoma after interventional treatment in a tertiary hospital were randomly divided into the experimental group and the control group using random number table,with 47 patients in each group. Hematoma was compressed by a sphygmomanometer cuff inflation. The sphygmomanometer cuff inflation pressure of the experimental group and the control group was higher than systolic blood pressure by 30 mmHg（1 mmHg=0.133 kPa） and 20 mmHg,respectively,and the pressure was decompressed for 1 min after 5 min of compression,for 5 repeated cycles,in which the control group was decompressed to 0 mmHg,and the experimental group was decompressed to the patients’ diastolic pressure. The comfort and pain of the patients in both groups were observed. The arm circumference,forearm tension and swelling were observed right after the compression and 30 min after the compression. Results During the compression process,there was no significant difference in the comfort and pain between two groups（P>0.05）. Immediately after the compression,there was no significant difference in the degree of swelling of the forearm between the two groups（P>0.05）. Immediately after the compression and 30 min after the compression,the improvement of arm circumference and forearm tension in the experimental group was better than those in the control group,and the differences were statistically significant（P<0.05）. After 30 min of compression,degree of forearm swelling in the experimental group was lower than that in the control group,and the difference was statistically significant（P<0.01）. Conclusion Keeping the sphygmomanometer cuff inflation pressure higher than patients’ systolic blood pressure by 30 mmHg, releasing pressure to patients’ diastolic pressure after five mins maintenance, maintaining pressure for one min and repeating for five circles can be beneficial to improve patients’ arm circumference, forearm tension and swelling degree.

Key words: Coronary Heart Disease, Coronary Intervention, Hematoma, Blood Pressure Cuff Compression, Nursing Care

乔积民, 佘莉萍, 常芸. 不同压力对减轻老年冠心病介入治疗患者前臂血肿的效果[J]. 中华护理杂志, 2020, 55(1): 74-77.

QIAO Jimin, SHE Liping, CHANG Yun. Effects of different cuff pressures on compression of forearm hematoma in geriatric patients with coronary heart disease[J]. Chinese Journal of Nursing, 2020, 55(1): 74-77.

图/表 4

表1 两组一般资料的比较[例（百分比,%）]

表2 两组舒适度与疼痛程度的比较[例（百分比,%）]

表3 两组臂围与前臂张力的比较[例（百分比,%）]

表4 两组前臂肿胀程度的比较[例（百分比,%）]

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